MSK/Derm

Question 1

What is mitochondrial myopathy?

Answer 1

Ragged red fibers; mitos have impaired oxidative phosphorylation = lactic acid

Question 2

Where do osteoblasts come from?

Answer 2

mesenchymal stem cells in the periosteum

Question 3

Hallmarks of multiple myeloma?

Answer 3

Think CRAB: 
hyperCalcemia 
Renal involvement 
Anemia
Bone lytic lesions (Il-1, TNF)

Multiple Myeloma: Monoclonal M protein spike

Question 4

Which nerve causes winged scapula?

Answer 4

long thoracic

Question 5

What causes muscle atrophy?

Answer 5

protein degradation in the muscle cells

Question 6

What does the musculocutaneous nerve do?

Answer 6

flex the bicep (lateral brachial plexus)

Question 7

Which structure is assoc w bullous pemphigoid (no blistering)?

Answer 7

hemidesmosomes (attach BM)

Question 8

Which structure is assoc w pemphigous vulgaris (blistering)?

Answer 8

desmosomes (attach epidermis to each other)

Question 9

Hip adductor muscle starts where? and inserts where?

Answer 9

ischium; femur

Question 10

What is osteonecrosis (avascular necrosis)?

Answer 10

Infarct of bone/BM at femoral head = collapse of bone w/o cartilaginous involvement (non-inflam)

Question 11

What causes osteonecrosis (avascular necrosis)?

Answer 11

ASEPTIC:
Alcoholism, 
Sickle cell disease, Storage (Gaucher), 
Exogenous/ Endogenous corticosteroids, 
Pancreatitis, 
Trauma, 
Idiopathic (Legg-Calvé-Perthes disease), 
Caisson (“the bends”)

Question 12

Which muscle protrudes the tongue? retracts the tongue?

Answer 12

protrude: genioglossus
retract: hyoglossus

Question 13

What test can help diagnose psoriatic arthritis?

Answer 13

slit lamp test for anterior uveitis which is assoc w psoriatic arthritis

Question 14

Injury to the lunate bone typically affects which nerve?

Answer 14

median = carpal tunnel

Question 15

What 2 symptoms indicate axillary nerve damage?

Answer 15

1. impaired shoulder abduction

2. loss of sensation over upper lateral arm

Question 16

When lifting weights, _____ of motor nerve action potentials increases.

Answer 16

frequency (force summation)

Question 17

Injury to the scaphoid bone typically leads to what condition??

Answer 17

avascular necrosis owing to retrograde blood supply.

Question 18

Injury to the hook of hamate typically affects which nerve?

Answer 18

ulnar

Question 19

Damage to which nerve causes foot drop?

Answer 19

common peroneal (lateral leg)

PED = Peroneal Everts and Dorsiflexes; if injured, foot dropPED.

Question 20

Damage to which nerve means you cant curl your toes?

Answer 20

tibial (back of leg)

TIP = Tibial Inverts and Plantarflexes; if injured, can’t stand on TIPtoes.

Question 21

Which nerve is responsible for Trendelenberg Sign?

Answer 21

Superior gluteal (glut med/min) = hip drop contra to lesion

Question 22

What drug is used to treat acute RA?

Answer 22

celecoxib (esp w GI issues)

Question 23

Injury to which nerve causes winged scapula?

Answer 23

long thoracic

Question 24

Pt comes with upper + lower motor weakness, mild ataxia, and opthalmoplegia, what do you think is compressed?

Answer 24

vertebral arteries at C6

Question 25

What 3 symps would suspect spinal nerve compression at cervical level (eg disc herniation)?

Answer 25

1. pain 2. burning/tingling 3. weak/numb shoulder, arm, or hands

Question 26

Succinylcholine in burn patients causes what set of ECG changes?

Answer 26

hyperkalemia --> peaked T waves

Question 27

What is thought to cause Paget Disease of the bone?

Answer 27

paramyxovirus infection of osteoclasts

Question 28

What is Forchheimer's sign?

Answer 28

Small, Red papules on the soft palate; caused by Rubella

Question 29

What is Alkaptonuria (ochronosis)?

Answer 29

deficiency of homogentisate oxidase --> accumulation of homogentisic acid

Question 30

What are the hallmarks of Alkaptonuria (ochronosis)?

Answer 30

1. arthralgias 2. bluish-black pigmentation (ochronosis) of ears, nose, cheeks 3. urine turns black on prolonged exposure to air

Question 31

The neurofibromas of NF1 are derived from what structures?

Answer 31

peripheral nerves

Question 32

What antibiotic is used to treat pustular acne?

Answer 32

tetracycline (bind to 30S and prevent attachment of aminoacyl-tRNA)

Question 33

What additional manifestation can accompany Klumpke palsy (lower trunk lesion)?

Answer 33

ipsi horner syndrome

Question 34

What nerve arises anteriorly to the anterior scalene muscle?

Answer 34

Phrenic

Question 35

Loss of innervation to what muscle causes "waiter's tip hand"?

Answer 35

Biceps brachii